More women skip periods for convenience

U. OREGON (US) — A large number of women deviate from the instructions on birth control pills to delay or skip monthly menstruation—not to avoid symptoms, but for convenience, new research suggests.

As research indicates reducing the occurrence of menstruation has been found to be safe and can even be beneficial, women are increasingly using hormonal contraceptives to alter bleeding cycles—but they are learning about the option from nonmedical sources.

“These findings emphasize the need for health care providers to carefully interview combined hormonal contraceptive users on how they are using their method—for example, many women may be skipping pills to extend their cycles,” says Christopher Minson, a human physiology professor at the University of Oregon.

“With a greater understanding of the issues, health care providers may be able to more effectively engage in conversations with college-aged women and educate them about available options.”

As reported in the journal Contraception, in a survey of undergraduate and graduate students, 17 percent reported altering their scheduled bleeding pattern by deviating from the instructions of hormonal contraceptives, which include birth control pills, vaginal contraceptive rings, and transdermal contraceptive patches.

Half of these women reported that they did so for convenience or scheduling purposes. Others cited personal preference (28.9 percent) or reducing menstrual symptoms (16.7 percent).

Among the women who delayed or skipped a scheduled bleeding for convenience or personal choice, a comparatively large number—53 percent—indicated they found out about the option from a family member or friend.

The survey also provides new insights on the factors that influence a woman’s decision whether to alter bleeding schedules. Asians have a 7 percent lower probability of altering hormonal cycles and women who exercise regularly have a 5 percent lower probability of doing so.

Another characteristic that decreased the likelihood of the practice was preference for a monthly cycle.

“We found that it is possible to identify some of the specific characteristics of women in a college population who may be more or less likely to practice scheduled bleeding manipulation,” says Paul Kaplan, of the University Health Center and Oregon Health and Sciences University.

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“This study provides information about the motives, beliefs, and influences relating to this practice.”

In a finding that surprised researchers, women who said they would prefer no menstrual periods were less likely to alter their cycles than those who would prefer one per year.

A woman who would prefer one cycle per year had a 17 percent higher probability of modifying her hormonal contraceptive regimen than one who preferred a menstrual period every three months or never.

This suggests that health care providers could improve education of the hormonal contraception regimen best-suited to a patient’s needs and desires, the researchers say.

From an estimated 11,900 survey-linked emails sent to female university students, 1,719 (14.4 percent) initial responses were received and 1,374 (79.9 percent of respondents) indicated that they had used a combined hormonal contraceptive during the last six months.